Acne Cosmetica: Causes, Treatment, and Prevention

Acne cosmetica is a mild but persistent form of acne triggered by the use of cosmetics. It can occur anywhere on the body but is most common on the face, neck, hairline, and scalp.

Acne cosmetica looks like small bumps across the surface of the skin or scalp. The skin will look and feel rough. Many comedones, and possibly some small papules and pustules, will be present. There usually is little to no inflammation.

This article covers the causes of acne cosmetica and offers tips for figuring out which cosmetic product is triggering your breakouts. It also includes treatment options and ways you can prevent this form of acne.

Acne Cosmetica Causes

Acne cosmetica is caused by the use of comedogenic hair or skin care products. When something is comedogenic, it causes acne by blocking the pores and hair follicles in your skin.

In this case, cosmetic products that are comedogenic build up within a hair follicle and block the pore. As a result, excess skin oil builds up in the pore, causing it to clog and a blemish to form.

Certain comedogenic products are well known to cause acne cosmetica, including:

• Pomades or hair oils
• Heavy moisturizers
• Eye creams
• Makeup

Furthermore, certain ingredients used in cosmetic products are known to be comedogenic, such as:

• Isopropyl myristate
• Lanolin
• Butyl stearate
• Stearyl alcohol
• Oleic acid

Algae extracts, coconut oil, and linseed oil are considered highly comedogenic as well.

Diagnosis

Not knowing the cause of your acne cosmetica breakouts can be frustrating. The good news is that, once you stop using the product that is triggering your breakouts, you should gradually start to see clearer skin.

Finding the Cause At Home

Before you can remove the culprit from your skincare routine, you will need to identify which cosmetic product it is. One way to do this is to narrow down the cause at home through a process of elimination.

Keep in mind that in most cases of acne cosmetica, breakouts don't occur instantly. Acne cosmetica breakouts take time to form—anywhere from a few days to six weeks after using a product.

Start your investigation by making a list of all the products you use on the area of skin where you are breaking out.

If you recently started using a new product and are suddenly breaking out, the connection may be obvious. See if your blemishes improve when you stop using the new product for a week or two.

Otherwise, choose one product from your list and stop using it for at least a week. If your skin starts to look better, you may have found the culprit. If not, try eliminating the next product on your list, one at a time, until you notice a change in your skin.

Conversely, you can also start with a "skin detox," in which you wear nothing on your skin for a month. Wash your skin in the morning and at night. If your skin is dry, you can use a moisturizer labeled "non-comedogenic."

Keeping your skin clean and applying as little product as possible should improve acne cosmetica within weeks. At this point, you can start to add one product at a time back into your skincare routine.

This way, if a breakout develops again, you will have a better idea of exactly which product or products could have led to it.

When to See a Dermatologist

The delay between when you use a product and when your breakouts occur can make it difficult to figure out which product is to blame.

You certainly do not have to stress yourself out over finding the cause of your acne cosmetica at home. If you have tried to eliminate skincare products and are still breaking out, you may not be dealing with acne cosmetica after all.

A qualified dermatologist can examine your blemishes to see if you have another form of acne, such as hormonal or cystic acne. While there are no tests for diagnosing acne, dermatologists can typically tell what type of acne you have simply by looking at your skin.

To further pinpoint the cause, your dermatologist may ask you questions, like whether your blemishes itch or get red and inflamed. They may ask you if you wash your face after working out, or whether you use powder or cream foundation.

This information will help them determine the right treatment for you.

Acne Cosmetica Treatment

The first step to treating your acne cosmetica is to give your skin a break and time to breathe and heal. Going makeup-less a few times per week is a great start.

Granted, just keeping your skin bare won't necessarily be enough to clear up your skin. You will likely need to take a few extra steps.

Acne Cleansers

Having a consistent cleansing routine is extremely important for all skin types—whether you have dry skin, oily skin, or skin that falls somewhere between.

To help clear existing breakouts more quickly, and to prevent new comedones from forming, use a cleanser or treatment pads containing salicylic acid.

Salicylic acid is what's known as a keratolytic (peeling) agent, meaning that it helps the skin break down and shed dead skin cells so that they don't clog your pores.

A handful of studies have shown positive results from using cleansers that contain salicylic acid. For example, one study examined the effects of a salicylic acid face cleanser in people ages 12 to 30 who had mild to moderate acne.

After eight weeks of using the cleanser, significant reductions in acne blemishes were reported. Researchers also noted that the salicylic acid cleanser was gentle, non-drying, and well-tolerated.

Even if you don't wear makeup, you should still cleanse your face in the morning, before bed, and any time you get extra sweaty, like after a workout. If you don't feel comfortable going makeup-less all day, be sure to cleanse your face as soon as you get home.

Exfoliants and Peels

To exfoliate means to remove dead skin cells from your skin's surface. Exfoliation has become very popular in past decades, in part because the smoothing and polishing effects of exfoliation can often be seen and felt right away.

Commonly used chemical exfoliants include mandelic acid, glycolic, lactic, and malic acids, as well as salicylic acid. You can find very low concentrations of these chemicals in over-the-counter exfoliants, like those you would purchase at a drug or beauty store.

Higher-concentration chemical exfoliants are available too, but they are more intensive and need to be applied by a qualified dermatologist or aesthetician. You may see this treatment referred to as a chemical peel.

For best results, use your over-the-counter exfoliant once per day, and always exfoliate after cleansing. This way, the cleanser can lift dirt, sweat, and makeup from your skin's surface, and then the exfoliant can penetrate deeper into your pores.

Over-the-Counter Medications

Drug and beauty store shelves have a plethora of OTC medicated acne creams, gels, ointments, and spot treatments to choose from.

Choosing one for yourself can be a bit overwhelming, so it helps to narrow down your search by keeping an eye open for specific active ingredients that fight acne.

There are two in particular to look out for: salicylic acid and benzoyl peroxide. You already know that salicylic acid fights breakouts by helping your skin shed dead skin cells. Benzoyl peroxide attacks bacteria on your skin and can assist salicylic acid in keeping your pores clean.

Both are highly effective for preventing clogged pores and breakouts, and they work well together, too. In fact, you may even come across a two-step acne treatment that contains both a salicylic acid cleanser and a benzoyl peroxide spot treatment.

Prescription Drugs

If you met with your dermatologist, they may or may not have prescribed an acne medication for you, depending on what type of acne you have and how severe it is.

Prescription acne treatments come in two forms: topical treatments in cream or ointment form and oral treatments in pill form.

Some kinds of prescription topical medications contain tretinoin, which is a type of retinoid made from vitamin A. Other kinds contain benzoyl peroxide or an antibiotic called clindamycin.

If your acne is more severe, you may be prescribed an oral medication. Oral medications are systemic, meaning that they are absorbed throughout your whole body. They may be a better option if you have acne that affects several skin areas.

Prescription oral medications include a daily antibiotic pill like tetracycline and oral isotretinoin. If you are a woman and your acne is hormonal, birth control pills may be an option for you.

That said, prescription acne treatments are typically offered in more severe cases when acne breakouts aren't responding to OTC treatments.

Home Remedies

Some studies have found that tea tree oil may be beneficial for acne, but more research is needed.

You can try it by mixing a few drops into your moisturizer. But do keep in mind that since some essential oils can be comedogenic, you may want to test the tea tree oil out on a small area of your skin first.

Manuka honey can have an anti-inflammatory effect on the skin. However, researchers have yet to confirm whether or not it is effective as an acne-fighting agent.

Witch hazel has garnered a lot of attention among the skincare community as well. This plant extract is an astringent, meaning that it removes excess oil and makeup from the skin and tightens pores.

While it sounds promising, there is not enough evidence to prove that witch hazel is effective for treating or preventing acne. It's also possible that witch hazel's oil-absorbing properties may be too drying and irritating for some skin types.

New Products

It is generally a good idea to switch makeup brands or products if your acne seems to worsen after wearing makeup for several days in a row.

Certain makeup formulations (even those labeled noncomedogenic) can cause acne breakouts if you are sensitive to certain ingredients in them.

If this seems to be the case for you, try another brand or product labeled noncomedogenic. Your skin might tolerate one better than another.

Prevention

You can help prevent pore blockages that cause acne cosmetica by following these basic tips:

• Choose products labeled noncomedogenic. Low-comedogenic ingredients include cetyl/cetearyl alcohol, polyethylene glycol, glycerin, and aloe vera.
• Switch to an oil-free moisturizer.
• Apply hair pomades and oils at least 1 inch back from the hairline or only on the ends of the hair.
• Make sure to thoroughly cleanse all traces of makeup from your face at the end of each day before going to bed.
• Clean your makeup brushes every week to remove bacteria and oil that can contribute to breakouts.

Summary

Acne cosmetica is acne caused by pore-clogging (comedogenic) cosmetics. Ingredients like lanolin and coconut oil are known to be comedogenic, and some types of products, like pomades and eye creams, tend to be more comedogenic than others.

If you know what is causing your acne cosmetica, simply avoiding it and using cleansers containing salicylic acid should lead to clearer skin. If your acne doesn't improve with at-home treatment, or if your acne is causing you distress, see a dermatologist.

A Word From Verywell

Having acne is normal, whether you are a teenager or an adult. While there are innumerable over-the-counter acne treatments available, the trial and error that can come with finding the right product for you can be difficult and costly. If you are feeling stressed or overwhelmed over your acne, go ahead and make an appointment with a dermatologist. You should never allow acne to rule your life.